Transvaginal Sacrospinous Ligament Fixation with or Without Concurrent Vaginal Hysterectomy: A Comparison of Operative Morbidity

Abstract

The operative parameters and short-term outcomes of sacrospinous ligament fixation for vaginal vault prolapse or for genital prolapse with concurrent vaginal hysterectomy were studied in 60 women who had undergone sacrospinous ligament fixation. Thirty had undergone sacrospinous ligament fixation for vault prolapse and were matched retrospectively with 30 women treated by both sacrospinous fixation and vaginal hysterectomy. Data on patient characteristics and perioperative events were collected retrospectively from the hospital records. Concomitant operations, duration of operation, blood loss, and complication rates were evaluated. Repair of pelvic floor relaxation was performed in both groups with similar frequency; 90% underwent anterior colporrhaphy, and 77% underwent colpoperineorrhaphy. The operation with vaginal hysterectomy lasted, on average, 21 minutes longer. Mean blood loss did not differ significantly between the groups: 360 ml for sacrospinous ligament fixation and 490 ml for the combined operation. The type of operation did not alter the complication rate: urinary tract infection in 22 (37%) and vaginal cuff infection in 9 (15%) patients were the most common complications. It is concluded that sacrospinous ligament fixation can safely be undertaken concurrently with vaginal hysterectomy and repair of pelvic floor relaxation for genital prolapse. (J GYNECOL SURG 16:101, 2000)